Clinical Diagnostics

Bacterial Vaginosis

Vaginosis is an infection of the vagina. Vaginitis is an inflammation of the vagina that may be due to vaginosis or other factors such as an allergy, irritant, or a decrease in the female hormone estrogen. Vaginitis is a very common condition, most frequently affecting women of child-bearing age. It has been reported by the Centers for Disease Control and Prevention (CDC) to affect over 21 million American women between the ages of 14 to 49 years. The condition can cause genital itching and burning and sometimes an abnormal vaginal discharge. When the external genitalia (vulva) are also inflamed, the condition may be referred to as vulvovaginitis. The most common terms used by the general public for vaginitis/vaginosis are "yeast infection" and "vaginal infection."


The vagina normally maintains a dynamic balance of normal flora - a mixture of "good" microorganisms that help protect the vagina, maintain its moderately acidic environment, and discourage the growth of disease-causing microorganisms. Lactobacilli are the most frequently encountered normal flora bacteria. A mixture of other microorganisms, such as corynebacteria, and some yeast may also be found.


A small amount of daily vaginal discharge is normal. This is usually clear or milky and varies in consistency and quantity during a woman's menstrual cycle. Anything that disrupts the balance of normal flora and/or that irritates the tissues of the vagina or vulva can potentially cause vaginitis. Vaginal symptoms such as abnormal discharge, unpleasant odor, itching, and burning are common reasons for gynecologic consultation and typically lead to a diagnosis of bacterial vaginosis (BV).

Available Tests
Bacterial Vaginosis Panel
Documents
Info Sheet  Requisition Form 
Test Information
Organism List: Atopobium vaginae, BVAB2, Gardnerella vaginalis, Lactobacillus crispatus, Lactobacillus gasseri, Lactobacillus iners, Lactobacillus jensenii, Megasphaera 1, Megasphaera 2, Mobiluncus curtisii, Mobiluncus mulieris, Prevotella bivia
 
Clinical Utility: Retrogen's Bacterial Vaginosis Program utilizes Thermo-Fisher's patented TaqMan technology, providing accurate diagnostic testing to identify and discriminate among 14 pathogens known to be responsible for bacterial vaginosis. The program only requires a single, non-invasive sample collection, has very short turnaround time and provides your referring physician a detailed, comprehensive report that leads to actionable decisions and forward treatment options.
 
Method: Retrogen carries out real-time PCR on DNA extracted from vaginal swabs to screen for microorganisms known to be associated with BV. This quantitative approach uses TaqMan chemistry from Life Technologies to detect 16S rRNA gene sequences from pathogenic bacterial species.
Ordering
Test ID: #8002
Turn-around Time: 24-48 hours
Preferred Specimen: Vaginal swab
Billing
CPT Codes: 87512
Billing Information: View Billing Information
Web Resources
  1. Mayo Clinic Staff (Updated 2012 February 25). Vagina: What's normal, what's not.
    http://www.mayoclinic.com/health/vagina/MY01913/METHOD=print through http://www.mayoclinic.com. Accessed March 2013.
  2. Gore, H. (Updated 2011 October 27). Vaginitis.
    http://emedicine.medscape.com/article/257141-overview through http://emedicine.medscape.com.
  3. Samra-Latif, O. (Updated 2012 January 13). Vulvovaginitis.
    http://emedicine.medscape.com/article/270872-overview through http://emedicine.medscape.com. Accessed March 2013.
  4. Leber, M. and Tirumani, A. (Updated 2012 April 16). Vulvovaginitis in Emergency Medicine.
    http://emedicine.medscape.com/article/797497-overview through http://emedicine.medscape.com. Accessed March 2013.
  5. CDC.
    Sexually transmitted diseases treatment guidelines. MMWR Recomm Rep 2010(https://www.cdc.gov/mmwr/preview/mmwrhtml/rr5912a1.htm);59(No. RR-12).
References
  1. Amsel R, Totten PA, Spiegel CA, et al. Nonspecific vaginitis: Diagnostic criteria and microbial and epidemiologic associations. Am J Med 74(1):14-22, 1983.
  2. Verstraelen H, Verhelsy R. Bacterial vaginosis: An update on diagnosis and treatment. Expert Rev Anti Infect Ther 7(9):1109-1124, 2009.
  3. Spiegel C, Amsel R, Holmes K. Diagnosis of bacterial vaginosis by direct gram stain of vaginal fluid. J. Clin. Microbiol. July 1983 vol. 18 no. 1, 170-177.
  4. Workowski, KA; Berman, S; Centers for Disease Control and Prevention, (CDC) (17 December 2010). "Sexually transmitted diseases treatment guidelines, 2010." MMWR. Recommendations and reports : Morbidity and mortality weekly report. Recommendations and reports / Centers for Disease Control. 59 (RR-12): 1-110.
  5. Warner L, Klausner JD, Rietmeijer CA, et al. Effect of a brief video intervention on incident infection among patients attending sexually transmitted disease clinics. PLoS Med 2008;5:919-27.
  6. Clement, Meredith E.; Okeke, N. Lance; Hicks, Charles B. (2014). "Treatment of Syphilis". JAMA. 312 (18): 1905.